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Mannerberg A, Konradsson E, Edvardsson A, Kügele M, Kadhim M, Ceberg C, Petersson K, Thomasson H, Arendt M, Børresen B, Bastholm Jensen K. PO-1711 Accurate FLASH delivery requires motion monitoring – SGRT is a feasible option for canine patients. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03675-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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2
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Lovgren N, Petersson K, Labarbe R, Hotoiu L, Fagerström Kristensen I. PO-1685 Creating clinically competitive FLASH proton therapy treatment plans. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03649-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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3
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Petersson K. SP-0017 For the motion (FLASH: Increasing the therapeutic index of radiotherapy). Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03870-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Petersson K, Konradsson E, Arendt M, Jensen KB, Børresen B, Kristensen A, Hansen A, Af Rosenschöld PM, Bäck S, Ceberg C. FLASH in the Clinic Track FLASH RADIOTHERAPY TREATMENT OF CANINE PATIENTS. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01446-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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5
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Karlsson T, Augustin H, Lindqvist M, Otten J, Petersson K, Storck-Lindholm E, Mogren I, Winkvist A. Effect of the New Nordic Diet compared with usual care on glucose control in gestational diabetes mellitus: Study protocol for the randomized controlled trial intervention with new Nordic DIet in women with GestatiOnal diabetes mellitus (iNDIGO). Contemp Clin Trials 2022; 115:106706. [DOI: 10.1016/j.cct.2022.106706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 11/03/2022]
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Jones G, Cooper C, Petersson K. FLASH Mechanisms Track (Oral Presentations) COMET ASSAY MEASURES INDICATE LOWER DNA DAMAGE LEVELS IN WHOLE BLOOD PBLS FOLLOWING EX VIVO ELECTRON FLASH EXPOSURES OVER 0.25–1% OXYGEN. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01556-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Adrian G, Brus A, Konradsson E, Eriksson S, Andresen T, Petersson K, Carneiro A, Hansen A, Ceberg C. FLASH Mechanisms Track (Oral Presentations) FLASH SPARING OF MELANOMA CELLS IN VITRO AND IN VIVO. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01461-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Konradsson E, Lempart M, Blad B, Petersson K, Ceberg C. ION COLLECTION EFFICIENCY IN A PLANE-PARALLEL TRANSMISSION CHAMBER OPERATED AT HIGH POLARIZING VOLTAGES IN A PULSED ELECTRON BEAM. Phys Med 2022. [DOI: 10.1016/s1120-1797(22)01665-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Konradsson E, Arendt M, Jensen K, Thomasson H, Børresen B, Petersson K, Ceberg C. Intracavitary Electron FLASH Radiotherapy in a Canine Cancer Patient With Oral Malignant Melanoma. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Van Den Heuvel F, Petersson K, Vojnovic B, Hill M, Vella A, Ryan A, Brooke M, Maughan T, Giaccia A. Oxygen Related Factors in FLASH Radiotherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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11
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Mannerberg A, Kügele M, Hamid S, Petersson K, Gunnlaugsson A, Bäck S, Engelholm S, Ceberg S. OC-0352: Increased accuracy in reduced time – surface guided RT for hypofractionated prostate cancer patients. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00376-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Konradsson E, Lempart M, Blad B, Ceberg C, Petersson K. OC-0634: Correction for ion recombination in a built-in monitor chamber at ultra-high dose rates. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00656-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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13
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Larsson E, Kilander H, Weinryb M, Vikström M, Petersson K. The Swedish study on improved contraceptive counselling for immigrant women postpartum. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.1068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Contraceptive choices postpartum have not previously been studied in Sweden. Being foreign born is a risk factor for induced abortion. Improving postpartum contraceptive counseling could potentially fulfill unmet needs for contraception.
This is an organizational case study using a Quality Improvement Collaborative (QIC) within the regular healthcare setting at 3 maternal health clinics in Stockholm. The active phase of the study was Sep2018-Sep2019. Quantitative and qualitative methods were combined. Routine registration of choice of postpartum contraception was introduced at the clinics and analyzed focusing on Swedish born and foreign-born women. Midwives and researchers met continuously, and during the active phase every 2-3 months in learning seminars with around 20 participants. During the learning seminars PDSA-cycles were used and areas of improvements for continuous performance measures were chosen. The midwives decided on and tested multiple evidence-based changes in contraceptive counselling and services during action periods. Goals were set and competency building in areas chosen by the midwifes were held. In addition, both foreign- and Swedish born women gave their input to the improvement areas. Qualitative data was analyzed through content analysis from field notes and verbatim transcripts.
Preliminary results show that the proportion of women choosing an effective contraceptive method (SARC or LARC) among immigrant women increased from 40% to 55% when comparing the start and the end of the project. The midwives reported how they had changed their approach when counselling women who were skeptical about contraception and tried to find a new way to meet women's needs.
As much as the QIC showed positive results, it was a small-scale study in 3 clinics in one geographical area. A larger study to determine and explain the effectiveness of QIC on the proportion of immigrant women choosing an effective contraceptive method postpartum is planned for 2021-2024.
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Affiliation(s)
- E Larsson
- Department of Women’s and Children’s Health, Karolinska Institute, Stockholm, Sweden
| | - H Kilander
- Region Jönköping county, Jönköping, Sweden
| | - M Weinryb
- Stockholm South General Hospital, Stockholm, Sweden
| | - M Vikström
- Maternal healthcare unit, Stockholm, Sweden
| | - K Petersson
- Department of Clinical Sciences, Obstetrics and Gynecology, The Swedish Pregnancy Register/Umeå University, Umeå, Sweden
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Kyroudi A, Petersson K, Ozsahin E, Bourhis J, Bochud F, Moeckli R. Exploration of clinical preferences in treatment planning of radiotherapy for prostate cancer using Pareto fronts and clinical grading analysis. Phys Imaging Radiat Oncol 2020; 14:82-86. [PMID: 33458319 PMCID: PMC7807626 DOI: 10.1016/j.phro.2020.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/26/2020] [Accepted: 05/29/2020] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Radiotherapy treatment planning is a multi-criteria problem. Any optimization of the process produces a set of mathematically optimal solutions. These optimal plans are considered mathematically equal, but they differ in terms of the trade-offs involved. Since the various objectives are conflicting, the choice of the best plan for treatment is dependent on the preferences of the radiation oncologists or the medical physicists (decision makers).We defined a clinically relevant area on a prostate Pareto front which better represented clinical preferences and determined if there were differences among radiation oncologists and medical physicists. METHODS AND MATERIALS Pareto fronts of five localized prostate cancer patients were used to analyze and visualize the trade-off between the rectum sparing and the PTV under-dosage. Clinical preferences were evaluated with Clinical Grading Analysis by asking nine radiation oncologists and ten medical physicists to rate pairs of plans presented side by side. A choice of the optimal plan on the Pareto front was made by all decision makers. RESULTS The plans in the central region of the Pareto front (1-4% PTV under-dosage) received the best evaluations. Radiation oncologists preferred the organ at risk (OAR) sparing region (2.5-4% PTV under-dosage) while medical physicists preferred better PTV coverage (1-2.5% PTV under-dosage). When the Pareto fronts were additionally presented to the decisions makers they systematically chose the plan in the trade-off region (0.5-1% PTV under-dosage). CONCLUSION We determined a specific region on the Pareto front preferred by the radiation oncologists and medical physicists and found a difference between them.
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Affiliation(s)
- A. Kyroudi
- Institute of Radiation Physics, Lausanne University Hospital, Rue du Grand-Pré 1, CH 1007 Lausanne, Switzerland
| | - K. Petersson
- Institute of Radiation Physics, Lausanne University Hospital, Rue du Grand-Pré 1, CH 1007 Lausanne, Switzerland
| | - E. Ozsahin
- Department of Radiation Oncology, Lausanne University Hospital, Rue du Bugnon 46, CH 1011 Lausanne, Switzerland
| | - J. Bourhis
- Department of Radiation Oncology, Lausanne University Hospital, Rue du Bugnon 46, CH 1011 Lausanne, Switzerland
| | - F. Bochud
- Institute of Radiation Physics, Lausanne University Hospital, Rue du Grand-Pré 1, CH 1007 Lausanne, Switzerland
| | - R. Moeckli
- Institute of Radiation Physics, Lausanne University Hospital, Rue du Grand-Pré 1, CH 1007 Lausanne, Switzerland
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Borg D, Sundberg J, Brun E, Kjellén E, Petersson K, Hermansson M, Johansson J, Eberhard J, Johnsson A. PALAESTRA: A phase II trial with short-course radiotherapy followed by chemotherapy as palliative treatment in esophageal adenocarcinoma. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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16
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Troensegaard Nielsen K, Huss Eriksson A, Funch Carlsen M, Engell K, Jansson J, Petersson K, Røpke M, Kemp P. 387 Ex Vivo Visualization and Extended Drug Release from a Dissolvable Microarray. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Konradsson E, Kügele M, Petersson K, Berg L, Gebre-Medhin M, Ceberg S. EP-1978 Surface guided coplanar and non-coplanar stereotactic radiotherapy with open masks – a phantom study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32398-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Ohlsson P, Petersson K, Augustsson P, Laurell T. Acoustic impedance matched buffers enable separation of bacteria from blood cells at high cell concentrations. Sci Rep 2018; 8:9156. [PMID: 29904138 PMCID: PMC6002537 DOI: 10.1038/s41598-018-25551-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/19/2018] [Indexed: 12/03/2022] Open
Abstract
Sepsis is a common and often deadly systemic response to an infection, usually caused by bacteria. The gold standard for finding the causing pathogen in a blood sample is blood culture, which may take hours to days. Shortening the time to diagnosis would significantly reduce mortality. To replace the time-consuming blood culture we are developing a method to directly separate bacteria from red and white blood cells to enable faster bacteria identification. The blood cells are moved from the sample flow into a parallel stream using acoustophoresis. Due to their smaller size, the bacteria are not affected by the acoustic field and therefore remain in the blood plasma flow and can be directed to a separate outlet. When optimizing for sample throughput, 1 ml of undiluted whole blood equivalent can be processed within 12.5 min, while maintaining the bacteria recovery at 90% and the blood cell removal above 99%. That makes this the fastest label-free microfluidic continuous flow method per channel to separate bacteria from blood with high bacteria recovery (>80%). The high throughput was achieved by matching the acoustic impedance of the parallel stream to that of the blood sample, to avoid that acoustic forces relocate the fluid streams.
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Affiliation(s)
- Pelle Ohlsson
- Departament of Biomedical Engineering, Lund University, Lund, Sweden.
| | - Klara Petersson
- Departament of Biomedical Engineering, Lund University, Lund, Sweden
| | - Per Augustsson
- Departament of Biomedical Engineering, Lund University, Lund, Sweden
| | - Thomas Laurell
- Departament of Biomedical Engineering, Lund University, Lund, Sweden.
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Petersson K, Jakobsson O, Ohlsson P, Augustsson P, Scheding S, Malm J, Laurell T. Acoustofluidic hematocrit determination. Anal Chim Acta 2017; 1000:199-204. [PMID: 29289309 DOI: 10.1016/j.aca.2017.11.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 11/16/2022]
Abstract
Hematocrit (HCT) measurements of blood from patients, blood donors and athletes are routinely performed on a daily basis. These measurements are often performed in centralized hospital labs by whole blood analyzers, which leads to long time-to-result. On site measurements, based on centrifugation can be done, but these assays require manual handling, are slow and can just measure HCT in contrast to the central lab whole blood analyzers. In this work, we present a microfluidic based method to measure HCT in blood samples by acoustic separation of whole blood into discrete regions of plasma and red blood cells. Comparison of the areas of the red blood cell and plasma regions gives an accurate HCT value, with a linear correlation to the centrifugation-based reference method. A readout can be performed within 2 s of acoustic actuation providing a readout accuracy of approximately 3% points (pp) HCT. Additional accuracy can be achieved by extending the acoustic actuation to 20 s, yielding an error of less than 1 pp HCT. This acoustic tool is optimal for integration into a lab-on-a-chip device with in-line measurements of different clinical parameters.
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Affiliation(s)
- Klara Petersson
- Department of Biomedical Engineering, Lund University, Sweden.
| | - Ola Jakobsson
- Department of Biomedical Engineering, Lund University, Sweden
| | - Pelle Ohlsson
- Department of Biomedical Engineering, Lund University, Sweden
| | - Per Augustsson
- Department of Biomedical Engineering, Lund University, Sweden
| | - Stefan Scheding
- Department of Hematology, Skåne University Hospital, Sweden; Molecular Hematology & Lund Stem Cell Center, Lund University, Sweden
| | - Johan Malm
- Department of Biomedical Engineering, Lund University, Sweden; Department of Translational Medicine, Clinical Chemistry, Lund University, Sweden
| | - Thomas Laurell
- Department of Biomedical Engineering, Lund University, Sweden; Department of Biomedical Engineering, Dongguk University, Seoul, South Korea
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Petersson K, Montay-Gruel P, Jaccard M, Boivin G, Germond J, Petit B, Bochud F, Bailat C, Bourhis J, Vozenin M. OC-0039: Unique sparing of spatial memory in mice after whole brain irradiation with dose rates above 100Gy/s. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30483-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Barone C, Ferguson S, Zajac A, Brown R, Reed J, Krueger C, Petersson K. 0699 In vitro screening of the anthelmintic efficacy of birdsfoot trefoil commercial varieties and cultivars against ovine Haemonchus contortus. J Anim Sci 2016. [DOI: 10.2527/jam2016-0699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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22
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Ohlsson P, Evander M, Petersson K, Mellhammar L, Lehmusvuori A, Karhunen U, Soikkeli M, Seppä T, Tuunainen E, Spangar A, von Lode P, Rantakokko-Jalava K, Otto G, Scheding S, Soukka T, Wittfooth S, Laurell T. Integrated Acoustic Separation, Enrichment, and Microchip Polymerase Chain Reaction Detection of Bacteria from Blood for Rapid Sepsis Diagnostics. Anal Chem 2016; 88:9403-9411. [DOI: 10.1021/acs.analchem.6b00323] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Pelle Ohlsson
- Department
of Biomedical Engineering, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - Mikael Evander
- Department
of Biomedical Engineering, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - Klara Petersson
- Department
of Biomedical Engineering, Lund University, Box 118, SE-221 00 Lund, Sweden
| | - Lisa Mellhammar
- Stem Cell Center, Lund University, BMC B10, Klinikgatan 24, SE-222 42 Lund, Sweden
| | - Ari Lehmusvuori
- Department
of Biochemistry/Biotechnology, University of Turku, Tykistökatu
6 A, FI-20520 Turku, Finland
| | - Ulla Karhunen
- Department
of Biochemistry/Biotechnology, University of Turku, Tykistökatu
6 A, FI-20520 Turku, Finland
| | - Minna Soikkeli
- Department
of Biochemistry/Biotechnology, University of Turku, Tykistökatu
6 A, FI-20520 Turku, Finland
| | - Titta Seppä
- Department
of Biochemistry/Biotechnology, University of Turku, Tykistökatu
6 A, FI-20520 Turku, Finland
| | - Emilia Tuunainen
- Department
of Biochemistry/Biotechnology, University of Turku, Tykistökatu
6 A, FI-20520 Turku, Finland
| | - Anni Spangar
- Department
of Biochemistry/Biotechnology, University of Turku, Tykistökatu
6 A, FI-20520 Turku, Finland
| | - Piia von Lode
- Abacus Diagnostica Oy, Tykistökatu 4 D, FI-20520 Turku, Finland
| | | | | | - Stefan Scheding
- Stem Cell Center, Lund University, BMC B10, Klinikgatan 24, SE-222 42 Lund, Sweden
| | - Tero Soukka
- Department
of Biochemistry/Biotechnology, University of Turku, Tykistökatu
6 A, FI-20520 Turku, Finland
| | - Saara Wittfooth
- Department
of Biochemistry/Biotechnology, University of Turku, Tykistökatu
6 A, FI-20520 Turku, Finland
| | - Thomas Laurell
- Department
of Biomedical Engineering, Lund University, Box 118, SE-221 00 Lund, Sweden
- Department
of Biomedical Engineering, Dongguk University, Seoul, Korea
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Jaccard M, Petersson K, Buchillier T, Bailat C, Germond J, Moeckli R, Bourhis J, Vozenin M, Bochud F. EP-1494: Absolute dosimetry with EBT3 Gafchromic films in a pulsed electron beam at high dose-rate. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32744-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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24
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Petersson K, Jaccard M, Vozenin M, Montay-Gruel P, Trompier F, Buchillier T, Germond J, Bochud F, Bourhis J, Bailat C. Dosimetry of ultra high dose rate irradiation for studies on the biological effect induced in normal brain and GBM. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)30172-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fransson H, Wolf E, Petersson K. Formation of a hard tissue barrier after experimental pulp capping or partial pulpotomy in humans: an updated systematic review. Int Endod J 2015; 49:533-42. [DOI: 10.1111/iej.12480] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 06/05/2015] [Indexed: 12/13/2022]
Affiliation(s)
- H. Fransson
- Department of Endodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - E. Wolf
- Department of Endodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - K. Petersson
- Department of Endodontics; Faculty of Odontology; Malmö University; Malmö Sweden
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Petersson K, Fransson H, Wolf E, Håkansson J. Twenty-year follow-up of root filled teeth in a Swedish population receiving high-cost dental care. Int Endod J 2015; 49:636-45. [PMID: 26139565 DOI: 10.1111/iej.12495] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 06/29/2015] [Indexed: 01/30/2023]
Abstract
AIM To study the 20-year survival rate and periapical status of root filled teeth in a Swedish population requiring high-cost dental care and to identify factors related to survival and normal periapical status at follow-up. METHODOLOGY The study population comprised 104 patients selected from four local health insurance districts with treatment plans including radiographs submitted for approval for reimbursement from the Swedish National Dental Insurance in 1977. In 1998, a clinical and radiographic follow-up examination was conducted, to register the status of 449 teeth identified as root filled at baseline. Differences in tooth survival and periapical status at follow-up, with reference to periapical status and quality of root filling at baseline, were analysed by chi-square tests. Multiple regression analysis was used to describe tooth survival and normal periapical status at follow-up, with the explanatory baseline variables: tooth type, type of restoration, type of post, quality of root filling, periapical status, marginal bone loss and caries. Differences were considered significant at a 5% level. RESULTS Two hundred and ninety (65%) of the root filled teeth survived at follow-up. Baseline variables associated with low odds for tooth survival were mandibular molar, maxillary premolar, prefabricated posts other than screw posts, severe marginal bone loss, caries and apical periodontitis (AP). Normal periapical status at follow-up was registered in 49% of the root filled teeth. Baseline variables associated with low odds for normal periapical status (high risk for AP) at follow-up were mandibular molar, maxillary premolar, AP, severe marginal bone loss and inadequate root filling quality. Of the root filled teeth with AP at baseline, 42% had been left untreated during the observation period, and at follow-up, the AP persisted in 57% of these teeth. CONCLUSIONS After 20 years, 65% of the root filled teeth had survived and one-third remained with a sound periapical condition, without any further treatment. Almost half of the APs registered at baseline were left without treatment, and more than half of them persisted after 20 years.
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Affiliation(s)
- K Petersson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - H Fransson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - E Wolf
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - J Håkansson
- Department of Periodontology, Institute of Odontology, University of Gothenburg, Gothenburg, Sweden
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Koch M, Wolf E, Tegelberg Å, Petersson K. Effect of education intervention on the quality and long-term outcomes of root canal treatment in general practice. Int Endod J 2015; 48:680-9. [PMID: 25112721 DOI: 10.1111/iej.12367] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 08/06/2014] [Indexed: 12/19/2022]
Abstract
AIM To compare the technical quality and long-term outcomes of root canal treatment by general practitioners of a Swedish Public Dental Service, before and after an endodontic education including Ni-Ti rotary technique (NiTiR). METHODOLOGY A random sample was compiled, comprising one root filled tooth from each of 830 patients, treated by 69 general practitioners participating in the education: 414 teeth root filled in 2002, pre-education, using primarily stainless steel instrumentation and filling by lateral compaction, and 416 teeth root filled post-education (2005), using mainly NiTiR and single-cone obturation. Follow-up radiographs taken in 2009 were evaluated alongside immediate post-filling radiographs from 2002 to 2005. The density and length of the root fillings were registered. Periapical status was assessed by the Periapical Index (PAI), using two definitions of disease: apical periodontitis (AP) (PAI 3 + 4 + 5) and definite AP (PAI 4 + 5). Tooth survival was registered. Root fillings pre- and post-education were compared using chi-square and Fisher's exact tests. Crude extraction rates per 100 years were calculated for comparison of tooth survival. Explanatory variables (type of tooth, root filling quality, periapical status, marginal bone loss, type and quality of coronal restoration) in relation to the dependent variable (AP at follow-up) were analysed by multivariable logistic regression. RESULTS Follow-up data were available for 229 (55%) of teeth treated pre- and 288 (69%) treated post-education: both tooth survival (P < 0.001) and root filling quality were significantly higher (P < 0.001) in the latter. However, there was no corresponding improvement in periapical status. Both pre- and post-education, root fillings with definite AP on completion of treatment had significantly higher odds of AP or definite AP at follow-up. For teeth treated post-education, inadequate root filling quality was significantly associated with AP at follow-up. CONCLUSIONS Despite a higher tooth survival rate and a significant improvement in technical quality of root fillings after the education, there was no corresponding improvement in periapical status.
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Affiliation(s)
- M Koch
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Endodontics, Public Dental Service, Sörmland County Council, Eskilstuna, Sweden
| | - E Wolf
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Å Tegelberg
- Faculty of Odontology, Department of Orofacial pain and jaw function, Malmö University, Malmö, Sweden
| | - K Petersson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Kyroudi A, Bochud F, Petersson K, Ozsahin M, Bourhis J, Moeckli R. PO-0900: Where do radiation oncologists and medical physicists look when they evaluate a patient treatment plan? Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40892-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Moeckli R, Kyroudi A, Ghandour S, Matzinger O, Petersson K, Ozsahin M, Bourhis J, Pachoud M. PO-0899: Dosimetric evaluation of deliverable and navigated Pareto optimal plans generated with MCO. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40891-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Jones R, Cheung A, Coleman T, Ballard P, D'Cruz C, Schuller A, Frigault M, Gu Y, Sai Y, Weiguo S, Ren Y, Qing W, Lindbom L, Petersson K. 392 Using modelling & simulation to integrate mouse PK–PD-efficacy with preliminary human PK data to inform the Phase II doses and schedule for the experimental c-Met inhibitor AZD6094 (Volitinib). Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70518-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mejàre IA, Bergenholtz G, Petersson K, Tranæus S. Estimates of sensitivity and specificity of electric pulp testing depend on pulp disease spectrum: a modelling study. Int Endod J 2014; 48:74-8. [PMID: 24579698 DOI: 10.1111/iej.12277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 02/26/2014] [Indexed: 12/01/2022]
Abstract
AIM To demonstrate how the spectrum of diseased pulps may influence sensitivity and specificity in diagnostic studies on pulp status. METHODOLOGY An original sample from a previous study consisting of 59 teeth scheduled for root canal treatment was used where the relationship between the response to electric pulp testing and the visual status of the pulp was evaluated. To alter the spectrum of diseased pulps, a hypothetical sample of asymptomatic teeth with deep caries lesions was added to the original sample. Sensitivity and specificity were then compared for the two samples. RESULTS In the original sample of 59 teeth, sensitivity was 72% and specificity 90%. When the spectrum of diseased pulps was altered, sensitivity decreased to 67% and specificity increased to 97%. The change in disease spectrum also decreased the prevalence of necrotic pulps. CONCLUSIONS The spectrum of diseased pulps included in a diagnostic study on the accuracy of electric pulp testing, and indirectly also disease prevalence (here pulp necrosis), influences estimates of sensitivity and specificity. This implies that estimates of diagnostic accuracy from one study with a particular tooth population spectrum may not apply to another tooth population with a different disease spectrum.
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Affiliation(s)
- I A Mejàre
- SBU (Swedish Council on Health Technology Assessment), Stockholm, Sweden
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Petersson K, Engström P, Knöös T, Ceberg C. OC-0385: A deliverability comparison of equivalent dual-arc VMAT plans generated in two different TPSs. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)30490-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fransson H, Petersson K, Davies JR. Effects of bacterial products on the activity of odontoblast-like cells and their formation of type 1 collagen. Int Endod J 2013; 47:397-404. [DOI: 10.1111/iej.12160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 06/29/2013] [Indexed: 01/12/2023]
Affiliation(s)
- H. Fransson
- Department of Endodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - K. Petersson
- Department of Endodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - J. R. Davies
- Department of Oral Biology; Faculty of Odontology; Malmö University; Malmö Sweden
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Tajudin AA, Petersson K, Lenshof A, Swärd-Nilsson AM, Aberg L, Marko-Varga G, Malm J, Lilja H, Laurell T. Integrated acoustic immunoaffinity-capture (IAI) platform for detection of PSA from whole blood samples. Lab Chip 2013; 13:1790-6. [PMID: 23515524 PMCID: PMC4207374 DOI: 10.1039/c3lc41269e] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
On-chip detection of low abundant protein biomarkers is of interest to enable point-of-care diagnostics. Using a simple form of integration, we have realized an integrated microfluidic platform for the detection of prostate specific antigen (PSA), directly in anti-coagulated whole blood. We combine acoustophoresis-based separation of plasma from undiluted whole blood with a miniaturized immunoassay system in a polymer manifold, demonstrating improved assay speed on our Integrated Acoustic Immunoaffinity-capture (IAI) platform. The IAI platform separates plasma from undiluted whole blood by means of acoustophoresis and provides cell free plasma of clinical quality at a rate of 10 uL/min for an online immunoaffinity-capture of PSA on a porous silicon antibody microarray. The whole blood input (hematocrit 38-40%) rate was 50 μl min(-1) giving a plasma volume fraction yield of ≈33%. PSA was immunoaffinity-captured directly from spiked female whole blood samples at clinically significant levels of 1.7-100 ng ml(-1) within 15 min and was subsequently detected via fluorescence readout, showing a linear response over the entire range with a coefficient of variation of 13%.
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Affiliation(s)
- A Ahmad Tajudin
- Department of Measurement Technology and Industrial Electrical Engineering, Lund University, Lund, Sweden
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English C, Veeger A, Finan E, Grossman-Garber D, Petersson K. Recruitment and Retention of Students Using the Academic Roadmap. J Acad Nutr Diet 2012. [DOI: 10.1016/j.jand.2012.06.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Petersson K, Gebre-Medhin M, Ceberg C, Engström P, Knöös T, Kjellén E. PO-0655 REDUCING HAEMATOLOGICAL TOXICITY FOR ADULT PATIENTS RECEIVING CRANIOSPINAL IRRADIATION WITH HELICAL TOMOTHERAPY. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70988-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Pigg M, List T, Petersson K, Lindh C, Petersson A. Diagnostic yield of conventional radiographic and cone-beam computed tomographic images in patients with atypical odontalgia. Int Endod J 2011; 44:1092-101. [DOI: 10.1111/j.1365-2591.2011.01923.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Petersson K, Ceberg C, Engström P, Knoos T. SU-E-T-809: A Grading-Study Based Tool to Assist in the Choice of Treatment Modality. Med Phys 2011. [DOI: 10.1118/1.3612773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Fransson H, Petersson K, Davies JR. Dentine sialoprotein and Collagen I expression after experimental pulp capping in humans using Emdogain®Gel. Int Endod J 2010; 44:259-67. [DOI: 10.1111/j.1365-2591.2010.01824.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Hegaard HK, Ottesen B, Hedegaard M, Petersson K, Henriksen TB, Damm P, Dykes AK. The association between leisure time physical activity in the year before pregnancy and pre-eclampsia. J OBSTET GYNAECOL 2010; 30:21-4. [DOI: 10.3109/01443610903315686] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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42
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Petersson K, Benedek H, Ceberg C, Engström P, Knöös T. EVALUATION OF SHAREPLAN – A COMPARISON WITH IMRT PLANS GENERATED WITH ONCENTRA MASTERPLAN. Radiother Oncol 2009. [DOI: 10.1016/s0167-8140(12)72770-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hegaard HK, Petersson K, Hedegaard M, Ottesen B, Dykes AK, Henriksen TB, Damm P. Sports and leisure-time physical activity in pregnancy and birth weight: a population-based study. Scand J Med Sci Sports 2009; 20:e96-102. [PMID: 19422639 DOI: 10.1111/j.1600-0838.2009.00918.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We examined the association between sports and other leisure-time physical activities during pregnancy and birth weight of babies born after 37 completed weeks of gestation. All Danish-speaking pregnant women attending routine antenatal care at the Department of Obstetrics, Aarhus University Hospital, Denmark, from August 1989 to September 1991 were invited to participate in the study. A total of 4458 healthy women who delivered after 37 completed gestational weeks participated in this study. The associations between sports (0, 1-2, 3+ h/week) or leisure-time physical activity (sedentary, light, and moderate to heavy) and birth weight were examined by linear and logistic regression and adjusted for potential confounding factors such as smoking, parity, schooling, pre-pregnancy body mass index and gestational age. The results showed that pregnant women who practiced sports or were moderate to heavy leisure-time physical active during the early second or the early third trimester gave birth to infants with a similar birth weight as inactive women. The proportion of newborns with a low (<2500 g) or a high birth weight (>/=4500 g) was also unchanged. In conclusion, in this large population-based study, we found no association between sports and leisure-time physical activity and low-birth weight, high-birth weight, or average-birth weight.
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Affiliation(s)
- H K Hegaard
- The Unit of Caring Sciences, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
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Sandgren A, Thulesius H, Petersson K, Fridlund B. 8084 ORAL Doing good care – a study of palliative home nursing care. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
OBJECTIVE To study fathers' perception of, and involvement in, their children's health. DESIGN Telephone interviews according to a structured guide. SETTING County of Skåne, Sweden. MAIN OUTCOME MEASURES Answers regarding care and upbringing of child, child's health and ill health, and role of father. SUBJECTS 237 fathers of small children. RESULTS Fathers seem to be involved in their children to a large extent, both in caring and playing activities with their children. Most of them (82%) think that the child's health is good, and half of them (55%) have, at some time, contacted a doctor. The fathers mention security, love and commitment as important factors for being a good father, and almost all (97%) think that they are good fathers. Yet, only slightly more than half of them (54%) state that they have sufficient time for the child. CONCLUSIONS Today, fathers are subject to quite different expectations to participate actively in their children's everyday life than was the case for previous generations. Therefore, more studies of fathers' involvement in their children are needed, as well as a new approach within the health care system to fathers' participation.
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Affiliation(s)
- A-C Hallberg
- Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.
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Abstract
We propose a model that is applicable to oral health education. The model describes the oral cavity in a complexity-based ecological context. This concept includes the premise that factors from different organisational levels (biological, individual, community, society) interact in a complex way with the potential to 'stress' the ecosystem and thereby provoke changes. This mode of action complies with the understanding of the oral cavity as a complex adaptive system. An ecological model is actively used in the undergraduate problem-based curriculum at the Faculty of Odontology, Malmö University, Sweden and has recently been applied as a conceptual basis for the new dental curriculum being established at the University of Tromsø in Northern Norway. The purpose is to encourage and promote an ecological, health-oriented view and to stimulate reflections on premises for oral health and diseases in an integrated context.
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Affiliation(s)
- H M Eriksen
- Institute of Clinical Dentistry, University of Tromsø, Tromsø, Norway.
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Abstract
AIM To evaluate the evidence on the formation of a hard tissue barrier after pulp capping in humans. METHODOLOGY A PubMed and CENTRAL literature search with specific indexing terms and a hand search were made. The authors assessed the level of evidence of each publication as high, moderate or low. Based on this, the evidence grade of the conclusions was rated as strong, moderately strong, limited or insufficient. RESULTS The initial search process resulted in a total of 171 publications. After reading the abstracts and hand searching the reference lists of the retrieved publications, 107 studies were retrieved in full-text and interpreted. After the interpretation, 21 studies remained and were included in the systematic review and given a level of evidence. No study had a high level of evidence, one study had moderate and 20 studies had a low level of evidence. There was heterogeneity between the studies; therefore, no meta-analysis was performed. The majority of studies on pulp capping using calcium hydroxide based materials reported formation of hard tissue bridging, studies on other pulp capping materials such as bonding agents presented inferior results. The evidence grade was insufficient. CONCLUSIONS Insufficient evidence grade does not necessarily imply that there is no effect of a pulp capping procedure or that it should not be used. Rather, the insufficient evidence underpins the need for high-quality studies.
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Affiliation(s)
- H Olsson
- Department of Endodontics, Faculty of Odontology, Malmo University, Malmo, Sweden.
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Abstract
AIM To investigate the effect of Emdogain Gel (Biora AB, Malmo, Sweden), consisting of a enamel matrix derivative (EMD) in a propylene glycol alginate (PGA) vehicle, on experimentally exposed human pulps and to register postoperative symptoms. METHODOLOGY Nine pairs of contralateral premolars scheduled for extraction on orthodontic indications were included. Following a superficial pulp amputation performed with a small (016) diamond bur, either EMDgel or a mix of calcium hydroxide and sterile saline was placed at random in contact with the pulp wound. The subjects made records of symptoms and were also interviewed about pain/discomfort by a blinded examiner. After 12 weeks the teeth were extracted, prepared and subjected to light microscopic examination in which the inflammation and newly formed hard tissue in the pulp were analysed. Immunohistochemistry was performed using affinity-purified rabbit anti-EMD polyclonal antibodies. RESULTS Postoperative symptoms were less frequent in the EMDgel-treated than in the calcium hydroxide-treated teeth, especially during the first six weeks. In the EMDgel-treated teeth, new tissue partly filled the space initially occupied by the gel and hard tissue was formed alongside the exposed dentine surfaces and in patches in the adjacent pulp tissue. EMD was detected in the areas where new hard tissue had been formed. The wound area of the EMDgel-treated teeth exhibited inflammation in the majority of the teeth whereas less inflammation was seen in the calcium hydroxide-treated teeth where the hard tissue was formed as a bridge. CONCLUSIONS In the EMDgel-treated teeth, postoperative symptoms were less frequent and the amount and pattern of hard tissue formation were markedly different than in the teeth treated with calcium hydroxide. However, the operative procedure and the formulation with EMD in a PGA vehicle do not seem to be effective for the formation of a hard tissue barrier.
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Affiliation(s)
- H Olsson
- Department of Endodontics, Faculty of Odontology, Malmö University, Sweden.
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Abstract
Superantigens (SAGs) cause a massive T-cell proliferation by simultaneously binding to major histocompatibility complex (MHC) class II on antigen-presenting cells and T-cell receptors (TCRs) on T cells. These T-cell mitogens can cause disease in host, such as food poisoning or toxic shock. The best characterized groups of SAGs are the bacterial SAGs secreted by Staphylococcus aureus and Streptococcus pyogenes. Despite a common overall three-dimensional fold of these SAGs, they have been shown to bind to MHC class II in different ways. Recently, it has also been shown that SAGs have individual preferences in their binding to the TCRs. They can interact with various regions of the variable beta-chain of TCRs and at least one SAG seems to bind to the alpha-chain of TCRs. In this review, different subclasses of SAGs are classified based upon their binding mode to MHC class II, and models of trimolecular complexes of MHC-SAG-TCR molecules are described in order to reveal and understand the complexity of SAG-mediated T-cell activation.
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